Personal medical device communication system and method

ABSTRACT

A personal and/or institutional health and wellness communications system, which may be used for a variety of emergency and non-emergency situations using two-way communication devices and a bi-directional communication network. In one application two-way pagers are adapted for use in the system. In one application cellular devices are adapted for use in the system. In one application an assisted living response center is established using various embodiments of the present personal and/or institutional communications system. The system provides multiple levels of prioritization, authentication of person (task, step, process or order), and confirmation via interrogation of person, device, or related monitor. One embodiment provides a method for receiving, evaluating and responding to calls received from a subscriber, patient, related party, or health care provider or health care system.

BACKGROUND OF THE INVENTION

[0001] The present application is a continuation-in-part of co-pendingU.S. patent application Ser. No. 09/956,474 filed Sep. 19, 2001, whichis a continuation of U.S. patent application Ser. No. 09/384,165, filedAug. 27, 1999 and now issued as U.S. Pat. No. 6,356,192, which claimspriority to U.S. provisional patent application serial No. 60/135,862,filed May 25, 1999 and to U.S. provisional patent application serial No.60/105,493 filed Oct. 23, 1998. The present application is also acontinuation-in-part of a co-pending U.S. patent application filed Mar.28, 2002, entitled “Method and System for Wireless Tracking”, whichclaims priority to a provisional patent application serial No.60/279,401, filed Mar. 28, 2001.

[0002] The present invention relates generally to bi-directionalpersonal and health-wellness provider communication system and inparticular to a personal communication system suitable for use withchildren, vulnerable adults (such as those in assisted livingsituations), and more specifically, medically distressed persons andthose in whom an personal medical device has been deployed, for medicaltesting, and for other life enhancements.

[0003] There are several trends which taken together are causing achange in the way medical services are delivered. Among other things,these include longer lifespan, medical technology improvements,automation of diagnostic processes, specialization of caregivers, therapid pace of technology that causes a shortening of the amortization ofdevelopment and investment costs, increasing expense of medical carecenters, and the shortage of health care workers.

[0004] The results of these trends are manifold. They include movingmore of the delivery of services out of a medical center and away fromthe direct supervision of highly trained medical personnel. They includeproviding personal medical devices to allow long-term patients to resumea more mobile lifestyle. They include allowing patients to be treatedfrom home for issues of cost and comfort. They include reducing thelevel of training associated with caregivers so that in some cases, evena casual passerby is able to provide meaningful assistance with devicesonce associated only with properly trained medical personnel, forexample using Portable Automated Defibrillators. However, the remotenessof patients from professional caregivers increases the need forcommunications systems to monitor the patient, deliver care, andcommunicate.

[0005] What is needed in the art is an improved detection system that isfriendly to a mobile user, that is easy to adapt to existing devices,that is easy to install, that is inexpensive, and that providessubstantial interoperability between wireless technologies,communication network providers, and other widely used medical andpublic systems.

SUMMARY OF THE INVENTION

[0006] One skilled in the art will readily recognize that theembodiments described solve all of these problems and many more notmentioned expressly herein.

[0007] Personal Medical Devices (PMD) take many forms. PMDs may besurgically implanted, strapped externally to the body, carried in apocket, transported in a carrying case, or installed as a homeappliance. They may be used only for rare emergencies, on an occasionalbasis, on a regular schedule, or in a continuous or nearly continuousfashion. PMDs may monitor individual or combinations of body functionssuch as heart function, respiration, body chemistry, brain function, ormuscular/skeleton actions. PMDs may provide body functions such asmechanical hearts, kidney dialysis, digestive or respiratory activities.PMDs may be used to deliver drugs, heart defibrillation, or othertreatment. PMDs may be used to enhance wellness, test drug therapies,monitor patient health, deliver long-term care, or treat acuteconditions.

[0008] We describe a device and method to couple with PMDs to providewireless communication and locating functions. The purpose forcommunications include but are not limited to the following: to providehealth care professionals with access to information for remotediagnostic capabilities; to provide notification of acute conditionspossibly requiring immediate assistance, transportation to a medicalcenter, or remote treatment action; to provide a location information ofmobile persons for caregivers; to notify responsible parties of theoccurrence of a medical condition; and to provide remote interventionassistance by caregivers through verbal or visual interaction.

[0009] In one embodiment, in order to provide mobility for users of PMDsin a public environment, we employ standard network communicationsystems to deliver a comprehensive medical communications service. Inone embodiment, the communications network links together the PMD,casual caregivers, a medical center, an emergency dispatch center,medical databases, and related responsible parties. This group ofassociated parties is able to combine resources to improve thesurvivability during an acute medical event.

[0010] In one embodiment, the medical communications system delivers anend-to-end comprehensive solution to provide care to a remote or mobileuser of a PMD.

BRIEF DESCRIPTION OF THE DRAWINGS

[0011]FIG. 1 is a block diagram showing the overall structure of thesystem of the present invention.

[0012]FIG. 2 is a block diagram showing the internal structure of aportable device.

[0013]FIG. 3 is a block diagram showing the structure of a userinterface module.

[0014] FIGS. 4A-4F are block diagrams showing various configurations ofthe system of the present invention.

[0015]FIG. 5 is a network diagram showing communications through thesystem of the present invention.

[0016]FIG. 6 is a chart showing the uses of various data by a dispatcheror medical caregiver.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0017] This detailed description provides a number of differentembodiments of the present system. The embodiments provided herein arenot intended in an exclusive or limited sense, and variations may existin organization, dimension, hardware, software, mechanical design andconfiguration without departing from the claimed invention, the scope ofwhich is provided by the attached claims and equivalents thereof.

[0018] The present system provides many benefits, including but notlimited to, low cost, easy installation, limited power requirements andwireless operation and signal transmission. Many other benefits will beappreciated by those skilled in the art upon reading and understandingthe present description.

[0019] U.S. Provisional Patent Application No. 60/098,392, filed Aug.29, 1998; U.S. Provisional Patent Application No. 60/098,270 filed Aug.28, 1998; U.S. Provisional Patent Application No. 60/105,493 filed Oct.23, 1998; and U.S. Provisional Patent Application No. 60/135,862 filedMay, 25, 1999, are all hereby incorporated by reference in theirentirety.

[0020] Personal Medical Device

[0021]FIG. 1 is a block diagram showing the interoperability of apersonal medical device (PMD) 100 with a medical device interface (MDI)200 and a network 400. As can be seen, the PMD 100 may interact directlywith the network 400 or through the mediation of the MDI 200.Alternatively, the PMD may interact with a personal wireless device 500which in turn interacts with the network.

[0022]FIG. 2 is a block diagram depicting the components of oneembodiment of a PMD 100. In one embodiment, the PMD includes a powermodule 110. The power module 110 may be a battery or a line connection.If a battery, it may be rechargeable. In one embodiment the PMD includesa memory 120. In one embodiment the PMD includes a processor 130. Theprocessor 130 executes instructions from its programming and also mayparticipate in data transfer between other components of the PMD 100.

[0023] Optionally, PMD 100 has connections to related external orembedded devices. In one embodiment, PMD 100 includes connections todetectors 140. Detectors 140 may be any sensor of bodily orphysiological parameters such as, but not limited to: temperature,motion, respiration, blood oxygen content, electrocardiogram (ECG),electroencephalogram (EEG), and other measurements.

[0024] Optionally, PMD 100 has connections to outputs 150. The outputsmay be signaled by changes in voltages, impedance, current, magneticfield, electromagnetic energy such as radio frequency signals, infraredsignals or optical signals, and audible or other forms of mechanicalenergy. The outputs may be direct changes of state, analog, or digitalin form. Several embodiments are possible, and the examples given hereinare not intended in a limiting or restrictive sense. The outputs may beactivated and controlled by the medical device interface 200 or theprocessor 130, or by the actuation of the detector 140 or a combinationof these. The outputs 150 may be used, for example, to actuatesolenoids, operate motors, or apply electrical current to the heart.

[0025] Optionally, PMD 100 has connections to data input/output ports160. Data I/O ports 160 may include, but are not limited to: serial,parallel, USB, etc.

[0026] Optionally, PMD 100 includes a User Interface Module (UIM) 200.The UIM 200 may allow users to view or enter data, conduct voicecommunications, use a camera to transmit images, or view a screen forgraphical images.

[0027] Optionally, PMD 100 includes a wireless communications module300. In one embodiment the wireless communications module includessystems and standards for Local Area Wireless 330. In one embodiment thewireless communications are designed to be Network Based Communications(NBC) 360.

[0028] User Interface

[0029]FIG. 3 depicts User Interface Module (UIM) 200. In one embodimentof UIM 200, display 220 is included. Display 220 may be any standarddevice for displaying information, such as a CRT, plasma display, LED,LCD, etc. or equivalent.

[0030] Preferably the UIM 200 includes data input means 240. Data inputmeans may be any standard means for inputting information, such as akeypad, touch screen, bar code scanner, telephone keypad, buttons,switches, etc., or equivalent.

[0031] In one embodiment of UIM 200, a speaker/microphone module 260 isincluded. Speaker/microphone module may be any device for producingsound, such as a speaker or microphone or the equivalent.

[0032] In one embodiment of UIM 200, a camera 280 is included. Camera280 may be a still camera, video camera, etc.

[0033] Communications

[0034] FIGS. 4A-4E depict various possible wireless communication pathsthat may be used by the PMD 100 to connect to the long-rangebi-directional network 400.

[0035]FIG. 4A depicts one embodiment of the present system. PMD 100communicates to Personal Wireless Device (PWD) 500 with local areawireless (LAW) 330. PWD 500 includes a LAW 330 compatible with LAW 330in PMD 100. In one embodiment, PWD 500 includes a UIM 200. PWD 500includes network based communications (NBC) 360. NBC 360 communicatesinformation received from LAW 330 to long-range bi-directional network400.

[0036]FIG. 4B depicts another embodiment of the present system. PMD 100communicates to the network 400 through NBC 360. LAW 330 is notemployed.

[0037]FIG. 4C depicts another embodiment of the present system. PMD 100communicates through data port 160 to Medical Device Interface (MDI)600. In one embodiment, MDI 600 includes a UIM 200. In this embodiment,MDI 600 includes a LAW 330 and communicates to PWD 500 through LAW 330.PWD 500 includes a LAW 330 compatible with MDI 600. Preferably, PWD 500includes UIM 200. Preferably, PWD 500 includes NBC 360 and communicatesto long-range bi-directional 400 through NBC 360.

[0038]FIG. 4D depicts another embodiment of the present system. PMD 100communicates through data port 160 to MDI 600. MDI 600 may include UIM200. Preferably, MDI 600 includes NBC 360 and communicates to long-rangebi-directional network 400 through NBC 360.

[0039]FIG. 4E depicts another embodiment of the present system. PMD 100communicates through LAW 330 to another PMD 100, which in turncommunicates through data port 160 to a third PMD 100.

[0040]FIG. 4F shows that a single medical device interface 600 cancommunicate simultaneously with multiple PMDs 100.

[0041] About Local Area Wireless Communications

[0042] LAW 330 may include, but is not limited to, infrared or radiofrequency (RF). Any suitable RF system that conforms to FCC requirementsand power requirements may be used. Preferably, the BLUETOOTH standardis used. BLUETOOTH is a 2.4 GHz wireless technology employed totransport data between cellular phones, notebook PCs, and other handheldor portable electronic gear at speeds of up to 1 megabit per second. TheBLUETOOTH standard was developed by the Bluetooth Special Interest Group(“BSIG”), a consortioum formed by Ericsson, IBM, Intel, Nokia, andToshiba. The BLUETOOTH standard is designed to be broadband compatibleand capable of simultaneously supporting multiple information sets andarchitecture, transmitting data at relatively high speeds, and providingdata, sound, and video services on demand. Of course, other suitablewireless communication standards and methods now existing or developedin the future are contemplated in the present invention. In addition,embodiments are contemplated that operate in conjunction with aBLUETOOTH or BLUETOOTH-like wireless communication standard, protocol,or system where a frequency other than 2.4 GHz is employed, or whereinfrared, optical, or other communication means are employed inconjunction with BLUETOOTH or BLUETOOTH-like wireless RF communicationtechniques.

[0043] In one embodiment, the present system includes a transceiver incompliance with BLUETOOTH® technical specification version 1.0, hereinincorporated by reference. In one embodiment, the present systemincludes a transceiver in compliance with standards established, oranticipated to be established, by the Bluetooth Special Interest Group.

[0044] In one embodiment, the present system includes a transceiver incompliance with standards established, or anticipated to be established,by the Institute of Electrical and Electronics Engineers, Inc., (IEEE).The IEEE 802.15 WPAN standard is anticipated to include the technologydeveloped by the BLUETOOTH® Special Interest Group. WPAN refers toWireless Personal Area Networks. The IEEE 802.15 WPAN standard isexpected to define a standard for wireless communications within apersonal operating space (POS) which encircles a person. In oneembodiment, the transceiver is a wireless, bi-directional, transceiversuitable for short-range, omni-directional communication that allows adhoc networking of multiple transceivers for purposes of extending theeffective range of communication. Ad hoc networking refers to theability of one transceiver to automatically detect and establish adigital communication link with another transceiver. The resultingnetwork, known as a piconet, enables each transceiver to exchangedigital data with the other transceiver. According to one embodiment,BLUETOOTH® involves a wireless transceiver transmitting a digital signaland periodically monitoring a radio frequency for an incoming digitalmessage encoded in a network protocol. The transceiver communicatesdigital data in the network protocol upon receiving an incoming digitalmessage.

[0045] According to one definition, and subject to the vagaries of radiodesign and environmental factors, short-range may refer to systemsdesigned primarily for use in and around a premises and thus, the rangegenerally is below a mile. Short-range communications may also beconstrued as point-to-point communications, examples of which includethose compatible with protocols such as BLUETOOTH®, HomeRFTM, and theIEEE 802.11 WAN standard (described subsequently). Long-range, thus, maybe construed as networked communications with a range in excess ofshort-range communications. Examples of long-range communication mayinclude, Aeris MicroBurst cellular communication system, and variousnetworked pager, cellular telephone or, in some cases, radio frequencycommunication systems.

[0046] In the event that transceiver includes a transceiver compatiblewith BLUETOOTH® protocol, for example, then the personal device may havesufficient range to conduct bidirectional communications over relativelyshort-range distances, such as approximately 10 to 1,000 meters or more.In some applications, this distance allows communications throughout apremise.

[0047] LAW 330 may include a separate, integrated or software basedshort-range bi-directional wireless module. The short-range network maybe based upon HomeRF, 802.11, Bluetooth or other conventional orunconventional protocols. However, these are short-range networks andthe meaning imposed herein is to include premises and facility basedwireless networks and not to describe long-range networks such ascellular telephone networks used to communicate over long-distances.Such a system may include programmable or automatically selectingelectronics to decide whether to conduct communications between thenetwork module and an optional base station using the short-range moduleor the network module. In one embodiment the system may employ differentportions of the network to provide short-range or long-range networkconnections, depending on the distance between the devices and the basestations. In one such embodiment, the network automatically adjusts fordifferent required transmission distances.

[0048] In one embodiment, the transceiver is compatible with both along-range communication protocol and a short-range communicationprotocol. For example, a person located a long distance away, such asseveral miles, may communicate with the transceiver using a cellulartelephone compatible with the long-range protocol of transceiver.

[0049] Other short-range communication protocols are also contemplatedand the foregoing examples are not to be construed as limitations butmerely as examples.

[0050] About Long-Range Bi-directional Network Based Communications

[0051] Long-range network based communications 360 refers to a type ofcommunications system that has a greater range than LAW 330, primarilybecause more power is available and/or because of an FCC license.

[0052] NBC 360 may include a long-range wireless communications network362, such as a cellular network, satellite network, paging network,narrowband PCS, narrowband trunk radio, or other wireless communicationnetwork. Combinations of such networks and other embodiments may besubstituted without departing from the present system.

[0053] In one embodiment, the long-range wireless network 362 is acellular communications network. In another embodiment, the long-rangewireless network is a paging network. In another embodiment thelong-range wireless network is a satellite network. In anotherembodiment the long-range wireless network is a wideband or narrowbandPCS network. In another embodiment the long-range wireless network is awideband or narrowband trunk radio module. Other networks are possiblewithout departing from the present system. In one embodiment, the NBC360 supports multiple network systems, such as a cellular module and atwo-way paging module, for example. In such embodiments, the system mayprefer one form of network communications over another and may switchdepending on a variety of factors such as available service, signalstrength, or types of communications being supported. For example, thecellular network may be used as a default and the paging network maytake over once cellular service is either weak or otherwise unavailable.Other permutations are possible without departing from the presentsystem.

[0054] The long-range wireless network 362 employed may be any consumeror proprietary network designed to serve users in range of the detectionsystem, including, but not limited to, a cellular network such as analogor digital cellular systems employing such protocols and designs asCDPD, CDMA, GSM, PDC, PHS, TDMA, FLEX™, ReFLEX™, iDEN™, TETRA™, DECT,DataTAC™, and Mobitex™, RAMNET™ or Ardis™ or other protocols such astrunk radio, Microburst™, Cellemetry™, satellite, or other analogue ordigital wireless networks or the control channels or portions of variousnetworks. The networks may be proprietary or public, special purpose orbroadly capable. However, these are long-range networks and the meaningimposed herein is not to describe a premises or facility based type ofwireless network.

[0055] The long-range wireless network 362 may employ various messagingprotocols. In one embodiment Wireless Application Protocol (WAP) isemployed as a messaging protocol over the network. WAP is a protocolcreated by an international body representing numerous wireless andcomputing industry companies. WAP is designed to work with most wirelessnetworks such as CDPD, CDMA, GSM, PDC, PHS, TDMA, FLEX, ReFLEX, iDEN,TETRA, DECT, DataTAC, and Mobitex and also to work with some Internetprotocols such as HTTP and IP. Other messaging protocols such as iMode™,WML, SMS and other conventional and unconventional protocols may beemployed without departing from the design of the present embodiment.

[0056] As an example, these long-range communication protocols describedabove may include, but are not limited to, cellular telephone protocols,one-way or two-way pager protocols, and PCS protocols. Typically, PCSsystems operate in the 1900 MHZ frequency range. One example, known asCode-Division Multiple Access (CDMA, Qualcomm Inc., one variant isIS-95) uses spread spectrum techniques. CDMA uses the full availablespectrum and individual messages are encoded with a pseudo-randomdigital sequence. Another example, Global Systems for Mobilecommunications (GSM), is one of the leading digital cellular systems andallows eight simultaneous calls on the same radio frequency. Anotherexample, Time Division Multiple Access (TDMA, one variant known asIS-136) uses time-division multiplexing (TDM) in which a radio frequencyis time divided and slots are allocated to multiple calls. TDMA is usedby the GSM digital cellular system. Another example, 3G, promulgated bythe ITU (International Telecommunication Union, Geneva, Switzerland)represents a third generation of mobile communications technology withanalog and digital PCS representing first and second generations. 3G isoperative over wireless air interfaces such as GSM, TDMA, and CDMA. TheEDGE (Enhanced Data rates for Global Evolution) air interface has beendeveloped to meet the bandwidth needs of 3G. Another example, Aloha,enables satellite and terrestrial radio transmissions. Another example,Short Message Service (SMS), allows communications of short messageswith a cellular telephone, fax machine and an IP address. Messages arelimited to a length of 160 alpha-numeric characters. Another example,General Packet Radio Service (GPRS) is another standard used forwireless communications and operates at transmission speeds far greaterthan GSM. GPRS can be used for communicating either small bursts ofdata, such as e-mail and Web browsing, or large volumes of data.

[0057] In one embodiment, a long-range communication protocol is basedon two way pager technology. Examples of two way pager protocols includeReFLEX™ (Motorola) format, InFLEXion© (Motorola) format, NexNet© (NexusTelecommunications Ltd. of Israel) format and others.

[0058] Other long-range communication protocols are also contemplatedand the foregoing examples are not to be construed as limitations butmerely as examples.

[0059] About the Personal Wireless Device and Medical Device Interface

[0060] A medical device interface 600 is similar to a personal wirelessdevice 500 except that network based communications 360 is optional witha medical device interface 600.

[0061] The personal wireless device 500 or medical device interface 600may be of several different designs. For example, in one embodiment itmay be a “response messaging” capable two-way pager. This is servicewhere a two-way pager receives a message and optional multiple-choiceresponses. The user can select the appropriate responses. Such a designmay be adapted to provide basic control options related to the system.

[0062] In another embodiment, the personal wireless device 500 ormedical device interface 600 may be a programmable two-way paging devicesuch as the Motorola PageWriter™ 2000. This is a class of device thatacts as both a two-way pager and a handheld computer also known as a PDA(Personal Digital Assistant).

[0063] In another embodiment, the personal wireless device 500 ormedical device interface 600 may be a cellular telephone. The cell phonemay be analog or digital in any of the various technologies employed bythe cell phone industry such as PCS, or CDMA, or TDMA, or others. Thecell phone may have programmable capability such as is found in a Nokia™9000 series of devices.

[0064] In embodiments where the user employs standard or adapted pagingor cell phones as their personal wireless device 500 or medical deviceinterface 600, security passwords may be entered by using numeric orother keys on a phone. In another embodiment, the security password maybe entered by speaking words. In this embodiment, the system may useword recognition, voice recognition or a combination of thesetechnologies. In the embodiment of a pager, a distinct order of pressingcertain keys could provide the equivalent of a security code. Forexample, 3 short and 1 long on a certain key; or once on key ‘a’, onceon key ‘b’, and once more on key ‘a’.

[0065] In another embodiment, the personal wireless device 500 ormedical device interface 600 is a handheld computer. Many personaldigital assistants (PDAs) offer programmable capability and connectivityto various types of long-range wireless networks. An example of thistype of device is the PalmPilot™ or Palm series of devices manufacturedby Palm, Inc. In these embodiments where a programmable personalwireless device 500 or medical device interface 600 is used such as aPalmPilot, PageWriter or programmable cell phone, the programmablenature of the devices facilitates the implementation ofindustry-standard designs and would allow for the development of aprogram written for the devices.

[0066] In another embodiment, a special manufactured device may bemanufactured to serve the needs of the system user.

[0067] In another embodiment, the personal medical device 100 isdirectly connected to a personal wireless device 500 that ismanufactured as an integrated unit.

[0068] About the Central Communications Base Station

[0069] In one embodiment, the personal medical device 100 communicateswith a device referred to herein as central communication base station700. Central communication base station 700 may include a firsttransceiver compatible with BLUETOOTH® or other short-range wirelessnetwork as described herein. Base station may provide a repeater serviceto receive a message using BLUETOOTH® and to retransmit the messageusing a different communication protocol or also using BLUETOOTH®communication protocol.

[0070] Base station 700 may also include a second transceiver or a wiredinterface having access to another communication network 750. The secondtransceiver or wired interface may retransmit the signal received fromthe personal device 100 or received from some other device. In this way,central communication base station 700 may serve to extend thecommunication range of the personal device. For example, a messagebetween the personal device and an emergency-dispatch center may becoupled to communication with the base station 700 connected network 750and a short-range wireless network. Communications between the personaldevice 100 and a device coupled to communicate with the base station 700connected network 750 may be considered long-range communications.

[0071] Base station may 700 also communicate bi-directionally within thepremise with one or more additional compatible devices. These may be asecond personal device 100 or any other device.

[0072] The base station connected network 750 may be a public switchedtelephone network (PSTN), a pager communication network, a cellularcommunication network, a radio communication network, the Internet, orsome other communication network. It will be further appreciated thatwith a suitable repeater, gateway, switch, router, bridge or networkinterface, the effective range of communication of a short-rangetransceiver may be extended to any distance. For example, base station700 may receive transmissions on a BLUETOOTH® communication protocol andprovide an interface to connect with the base station connected network750, such as the public switched telephone network (PSTN) using the basestation link. In this case, a wired telephone at a remote location canbe used to communicate with the personal device 100. As another example,the range may be extended by coupling a BLUETOOTH® transceiver with acellular telephone network, a narrow band personal communication systems(“PCS”) network, a CELLEMETRY® network, a narrow band trunk radionetwork or other type of wired or wireless communication network.

[0073] Examples of devices compatible with such long-range protocolsinclude, but are not limited to, a telephone coupled to the publicswitched telephone network (PSTN), a cellular telephone, a pager (eitherone way or two way), a personal communication device (such as a personaldigital assistant, PDA), a computer, or other wired or wirelesscommunication device.

[0074] In one embodiment, the long distance network 750 may include atelephone network, which may include an intranet or the Internet.Coupling to such a network may be accomplished, for example, using avariety of connections, including a leased line connection, such as aT-1, an ISDN, a DSL line, or other high-speed broadband connection, orit may entail a dial-up connection using a modem. In one embodiment, thelong distance network 750 may include a radio frequency or satellitecommunication network. In addition, one or more of the aforementionednetworks may be combined to achieve desired results.

[0075] Short-range communication protocols, compatible with the basestation may include, but are not limited to, wireless protocols such asHomeRFTM, BLUETOOTH®, wireless LAN (WLAN), or other personal wirelessnetworking technology. HomeRFTM, currently defined by specification 2.1,provides support for broadband wireless digital communications at afrequency of approximately 2.45 GHz.

[0076] Other long-range and short-range communication protocols are alsocontemplated and the foregoing examples are not to be construed aslimitations but merely as examples.

[0077] The base station 700 may be compatible with more than onecommunication protocol. For example, the base station may be compatiblewith three protocols, such as a cellular telephone communicationprotocol, a two-way pager communication protocol, and BLUETOOTH®protocol. In such a case, a particular personal device 100 may beoperable using a cellular telephone, a two-way pager, or a devicecompatible with BLUETOOTH®.

[0078] In one embodiment, the personal device 100 can communicate with aremote device using more than one communication protocols. For example,the personal device may include programming to determine which protocolto use for communicating.

[0079] The determination of which communication protocol to use tocommunicate with a remote device may be based on power requirements ofeach transceiver, based on the range to the remote device, based on aschedule, based on the most recent communication from the remote device,or based on any other measurable parameter. In one embodiment, thepersonal device 100 communicates simultaneously using multipleprotocols.

[0080] In one embodiment, there are various types of networks connectedto the base station 700. These may be telephone networks, modemconnections, frame relay systems, spread-spectrum, DSL, cable modems,dedicated line or other similar wire based communication and datanetworks. In addition, these may be long-range, bi-directional, wirelessnetworks as describe above.

[0081] In one embodiment, there is a connection to the Internet usingvarious Internet protocols such as TCP/IP/HTTP/HTCP and others.

[0082] Other Connections from the Personal Medical Device

[0083] In one embodiment, signals generated by the medical device arereceived by a central monitoring station 800. The central monitoringstation 800 may include operators that provide emergency dispatchservices. An operator at the central monitoring station 800 may alsoattempt to verify the authenticity of a received alarm signal. In oneembodiment, the alarm signal generated by the personal device 100 isfirst transmitted to a user, using either a short-range or long-rangecommunication protocol, who then may forward the alarm signal to amonitoring station if authentic or cancel the alarm signal if the alarmis not valid.

[0084] In one embodiment, the personal device 100 may communicate with abuilding control or security system 900 by communicating using itstransceiver. For example, the personal device may operate as anauxiliary input to a building control or security system. In which case,if the personal device 100 detects a security event, by way of a sensorcoupled to the personal device, then an alarm signal is transmitted fromthe personal device, via its transceiver, to the building securitysystem. The building security system, if monitored by a centralmonitoring station, then forwards the alarm signal to the monitoringstation. In one embodiment, the personal device 100 can receive atransmission from a separate building control or security system. If thebuilding security system detects an alarm condition, then the securitysystem can, for example, instruct the personal device to repeatedlytoggle power to load a flashing light visible from the exterior of thebuilding that may aid emergency personnel in locating an emergency site.Alternatively, the personal device can establish communications with apredetermined remote device or a central monitoring service.

[0085] Routing Paths from the Personal Medical Device

[0086] The present invention includes, but is not limited to, thefollowing routing paths from the personal device 100:

[0087] 1) short-range wireless to long-range wireless in a pre-designedsystem. That is, both the personal device 100 and the device with whichit communicates have been set up in communication in advance. Forexample, the personal device 100 is connected to a short-range wirelessmodule that communicates to a cell phone or other wireless networkdevice carried by the user.

[0088] 2) short-range wireless to long-range wireless “ad hoc”: thepersonal device sets up a short-range “ad hoc” network to any availablelong-range network connection.

[0089] 3) short-range wireless to any network connection. For example,the personal device 100 is connected to a short-range wireless modulethat communicates to a telephone or Internet base station in a person'shome.

[0090] 4) long-range wireless directly. For example, the personal device100 is directly connected to a long-range wireless network module.

[0091] Transmission to the Personal Medical Device

[0092] In addition, feedback may be transmitted to a remote device basedon the operation of the personal device. For example, if a user issues acommand to the personal device using a cellular telephone, then thedisplay of the phone will indicate the changes arising from the command.In one embodiment, the cellular telephone, the base station, emergencymonitoring center, or other device displays real time information fromthe personal device 100.

[0093] Various methods may be used to communicate with, or send amessage or instruction to, the personal device 100 from a remotelocation. For example, using a cellular telephone, a user may speak aparticular phrase, word or phoneme that is recognized by the cellulartelephone which then generates and transmits a coded message to thepersonal device 100. As another example, the user may manipulate akeypad on the telephone to encode and transmit a message to the personaldevice.

[0094] Data Types Communicated to and from the Personal Medical Device

[0095] Table I below shows the types of data that may be communicated toand/or from the personal device 100, and the direction of data flow.TABLE I Data Type Direction of transmission diagnosis (suggested byPMD/MDI or from bi-directional medical center manual request from PMDidentification (e.g., bluetooth serial from PMD number, PMD ID, accountnumber) use alert (e.g., opening a container, etc.) from PMD activation(shock, release medication, brain bi-directional stimulation) bodyreading (electrical, chemical, analog, from PMD digital, mechanical,temperature, etc.) two-way voice (to responding agency, bi-directionalbystander, or patient) digital instructions bi-directional standard I/Oports bi-directional camera: visual, video exhange bi-directionalauthorizations and authentications bi-directional Security codes, dataconfirmations, bi-directional acknowledgements transceiver activation to PMD encryption bi-directional interaction with related PMDsbi-directional verification (alarms, emergencies) bi-directional

[0096] Data Flow Examples

[0097] One possible example of data flow to and from the personal device100 is shown in FIG. 5.

[0098] The personal device 100 may be implanted in the victim V, orcarried on the person of the victim V. For example the personal device100 may be a pacemaker that is imbedded in the chest cavity of thevictim V and connected by leads to the victim's heart, as is well knownin the art.

[0099] In this example, the victim V undergoes some sort of cardiacproblem, such as tachycardia, that causes the personal device 100 toattempt to establish communication with a caregiver. While this is goingon, a bystander B attempts to give aid to the victim V. The bystander Bis carrying on his person a medical device interface 500 or a personalwireless device 600. When the personal device 100 attempts to establishcommunication, it sets up communication with the personal wirelessdevice 600 by local area wireless 330. For example, if the personaldevice 100 and personal wireless device 600 both use BLUETOOTH for localarea wireless communications, the personal device 100 and personalwireless device 600 will follow the communications protocols of theBLUETOOTH standard and establish communications.

[0100] Next, the personal device 100 may request the personal wirelessdevice 600 to establish a connection to the dispatcher or medicalcaregiver D, using network based communications 360. For example, thepersonal wireless device 600 may be a cell phone or PDA. Using networkbased communications 360, the personal wireless device establishes aconnection to the computer of the dispatcher or medical caregiver D.

[0101] Alternatively, the personal wireless device 600 may establish aconnection to an automatic processor P, which has database DB thatcontains information on the victim's medications, medical history,pre-existing conditions, possible diagnoses, personal records, personaldevice information, treatment strategies, response plans, identities orresponsing agencies, and other data.

[0102] Either the dispatcher D or the processor P may then send aninquiry through the personal wireless device 600 to the personal device100, instructing the personal device 100 to send various data, forexample, electrocardiogram data. Using this transmitted data, thedispatcher or processor may then make a diagnosis and identify atreatment strategy.

[0103] The dispatcher D may then alert responding personnel R, such as aparamedic unit, to travel to the victim V. In the event that thevictim's personal device 100 has location identification capability(discussed below), the dispatcher D will be able to give the exactlocation of the victim to the responding personnel R. The dispatcher Dmay also alert responsible parties RP such as the victim's parents ofthe location.

[0104] Until the responding personnel R reach the scene, the dispatcherD may establish voice communications with the bystander B through thebystander B's personal wireless device 600. The dispatcher may ask thebystander B to use the camera 280 of the personal wireless device totransmit an image of the victim V. The dispatcher D may give thebystander B instructions on how to render first aid to the victim Vuntil the responding personnel R arrive.

[0105] When the responding personnel R reach the victim, they mayestablish communications through local area wireless 330 from theirmedical device interface 500 to the victim's personal device 100,request data from the personal device 100, and request the personaldevice 100 to take some action, such as dispensing medication to thevictim V. Their medical device interface 500 may also establishcommunication with the dispatcher D or medical caregiver using networkbased communications 360.

[0106] The above is just one example of possible data flow to and fromthe personal device 100. Many other scenarios are possible.

[0107]FIG. 6 summarizes data flow from the point of view of a remotecaregiver, showing that comprehensive data creates the best options forthe remote caregiver.

[0108] Location Management

[0109] Optionally, the personal device 100 includes the ability todetect its own location and to communicate this location to authorizedrequesters. The location-determining function may be device-based,network-based, or a combination of device-based and network-based, asdescribed in co-pending U.S. Patent Application entitled “Method andSystem for Wireless Tracking”, filed Mar. 28, 2002, herein incorporatedby reference, in the Detailed Description, and in FIGS. 4A, 4B and 4Ctherein.

[0110] As discussed in the referenced patent application (FIG. 4A), thepersonal device 100B may include a GPS receiver positioned internal todevice 100b. FIG. 4B of the referenced patent illustrates acommunication network 200A having integral LDS 165A. Locationinformation, in one embodiment, is based on a geographical location offirst device 100C and is determined based on timing information forwireless signals between network 200A and device 100C. Second device 300is also connected to communication network 200A. In one embodiment, aserver coupled to network 200A includes programming to determinelocation information and selected clients accessing the server are ableto receive the location information. Selected clients are thoseauthorized to receive the location information. FIG. 4C of thereferenced patent application illustrates LDS 145B and LDS 165B withinfirst device 100D and network 200B, respectively. In such an embodiment,the combination of information generated by LDS 145B and LDS 165Bprovides the location information.

[0111] As described in the referenced patent application, the device 100may include an electronic circuit or an electronic circuit andprogramming to determine location. In one embodiment, LDS 145 uses aterrestrial location system. There are several varieties of terrestrialsolutions, including time differential, signal strength, angle ofarrival and varieties of triangulation. In one described embodiment, LDS145 uses a combination of terrestrial and satellite navigation systems.

[0112] Security

[0113] The system and method of the present invention may also includevarious types of security arrangements.

[0114] It will be appreciated that the ability of various entitiesspread around a network to receive and/or transmit to and control thepersonal device 100 requires some measure of security. Only authorizedagents should be allowed access to the device 100. For example, in theexample shown in FIG. 5, only responding personnel RP (such as trainedparamedics) who are on the scene of the event may be allowed to send acommand to the personal device 100 causing the personal device 100 todispense medication to the victim. Certainly, the bystander B should notbe allowed this level of access, even though the bystander B's personalwireless device 600 may be acting as an intermediary in communicationfrom the personal device 100 to the dispatcher D.

[0115] The following are possible embodiments of security and not meantto be exclusive.

[0116] First, data transmitted to and from the personal device 100 maybe encrypted by standard encryption algorithms, making it essentiallyimpossible for the unsophisticated interceptor to interpret the data.

[0117] Second, voice and visual channels of transmission may becontrolled for activation by the personal device 100 or by an authorizedentity, but may not necessarily be encrypted.

[0118] Third, security keys may be held by a central agency and providedto the responding personnel RP.

[0119] Fourth, the user of the personal device 100 may have a securitykey that he can enter to release information or access to authorizedparties.

[0120] A number of strategies may be employed for authorization andauthentication. For example, biometrics may be used. Biometrics refersto the measurement of some bodily parameter (such as fingerprint,retinal scan, etc.) that is unique to the individual.

[0121] Second, a public/private key system can be used in which accessto both keys is required for decoding an encrypted message. Each partythat wishes to participate in secure communications must create a keyset for encrypting and decrypting messages. One key is private and theother is public. The public key is for exchanging with other partieswith whom you who wish to participate in secure communication sessions.Each individual owner must keep the private portion of the key secure.The private key also has a secret pass phrase, in the event that it isever ‘misappropriated’. Public key/private key technology allows thesender to sign a message with their private key. When the recipientreceives the message, they can validate the authenticity of thesignature because they have the sender's public key.

[0122] Third, a user needing access to the device 100 may make a requestfor such access to a responsible third party.

[0123] Fourth, the personal device 100 may have pre-authorized authorityfor certain users.

[0124] A number of authorization strategies are discussed in co-pendingU.S. Patent Application, entitled “Method and System for WirelessTracking”, filed Mar. 28, 2002, herein incorporated by reference, in theDetailed Description.

[0125] About Power Management

[0126] In a number of scenarios, the power consumed by the personaldevice 100 is critical. For example, it the personal device 100 isimplanted in a human being, long battery life is essential.

[0127] Although some communications systems, such as BLUETOOTH, have lowpower consumption states, nevertheless power is being consumed. Further,in an environment such as BLUETOOTH, a BLUETOOTH transceiver that ispowered on may constantly be wakened from the low power states whenevera transmission is received from another BLUETOOTH transceiver.

[0128] It is therefore an important aspect of the present invention toprovide a completely powered-off state for the bi-directionalcommunications module, and for a means of signaling the bi-directionalcommunications module to transition from the powered-off state to thepowered-on state. The transceiver must consume no power in thepowered-off state.

[0129] A number of mechanisms for doing this signaling are possible.First, a mechanical signal, such as throwing a switch or applyingpressure to a pad, may be used. Second, a magnetic signal may be used,as in passing a magnet in the vicinity of the communications module.Third, sound or ultra-sound may be used. Fourth, infrared may be usedprovided there is a direct line of sight to the communications module.Sixth, radio frequency may be used, which has the advantage of notrequiring line of sight to the communications module.

[0130] Radio frequency is already being used for applications such asautomated meter reading and electronic article surveillance. Suchapplications included un-powered RF receivers such as RFID tags.

[0131]FIG. 7 shows a general block diagram of this power managementfunction. The personal device 100 is modified to include an un-poweredRF receiver 710 that is tuned to a particular frequency. Power-up device800 has an RF transmitter tuned to the same frequency. When a signal issent to the RF receiver 710, the receiver 710 gathers the RF energy andactivates logic 720. Any code transmitted on the frequency is passed tothe logic 720, which decodes it and compares it to a proper wake-upcode. If a proper wake-up code is received, logic 720 signals theprocessor 130 to power-on the communications module 300. The wake-upcode is optional, in that the receiver 710 may just signal the processor130 directly without decode.

What is claimed:
 1. A bi-directional wireless communication systemcomprising: (a) a first personal device, the first personal devicefurther comprising: (i) a processor; (ii) a memory; (iii) a powersupply; (iv) at least one detector input; and (v) a short-rangebi-directional wireless communications module; (b) a second devicecommunicating with the first device, the second device having ashort-range bidirectional wireless communications module compatible withthe short-range bi-directional wireless communications module of thefirst device; and (c) a security mechanism governing informationtransmitted between the first personal device and the second device. 2.The system of claim 1, wherein the security mechanism encrypts theinformation.
 3. The system of claim 1, wherein the security mechanismemploys authorization by the first personal device.
 4. The system ofclaim 1, wherein the security mechanism employs a key held by an agentand transmitted to the second device or wherein the security mechanismemploys a key entered by a user of the first personal device.
 5. Thesystem of claim 1, wherein the security mechanism employs a private keyand a public key.
 6. The system of claim 1, wherein the securitymechanism employs biometrics.
 7. The system of claim 1, furthercomprising a detector connected to the at least one detector input. 8.The system of claim 7, wherein the detector senses body or physiologicalparameters.
 9. The system of claim 8, wherein the body or physiologicalparameters are selected from the group consisting of temperature,motion, respiration, blood oxygen content, and electroencephalogram. 10.The system of claim 1, wherein the first personal device furthercomprises a user interface module.
 11. The system of claim 10, whereinthe user interface module further comprises a display, a data inputmeans, and a speaker/microphone module.
 12. The system of claim 10,wherein the user interface module further comprises a camera.
 13. Thesystem of claim 1, wherein the short-range wireless communicationsfurther comprises BLUETOOTH technology.
 14. The system of claim 1,wherein the first personal device further comprises a data input/outputport, the second device further comprises a data input/output port, andwherein the second device communicates with the first personal deviceusing the data input/output ports.
 15. The system of claim 1, furthercomprising a central communications base station communicating with thefirst personal device using short-range wireless communications.
 16. Thesystem of claim 15, wherein the short-range wireless communications isselected from the group consisting of HomeRF™, BLUETOOTH, and wirelessLAN.
 17. The system of claim 15, wherein the central communications basestation further comprises long-range wireless communications.
 18. Thesystem of claim 17, wherein the long-range wireless communications isselected from the group consisting of cellular, satellite, paging,narrowband PCS, and narrowband trunk radio.
 19. The system of claim 18,further comprising long-range messaging protocols executing over thelong-range wireless communications.
 20. The system of claim 19, whereinthe long-range messaging protocols are selected from the groupconsisting of wireless application protocol, cellular telephoneprotocols, one-way pager protocols, two-way pager protocols, and PCSprotocols.
 21. The system of claim 15, wherein the centralcommunications base station further comprises an interface to along-distance telephone network.
 22. The system of claim 15, wherein thecentral communications base station further comprises a connection tothe Internet.
 23. The system of claim 1, further comprising a centralmonitoring station receiving alarm signals from the first personaldevice.
 24. The system of claim 1, wherein the first personal devicefurther comprises a location determination module that determines thegeographical location of the first personal device.
 25. The system ofclaim 24, wherein the location determination module further comprises aGPS receiver.
 26. The system of claim 1, wherein the bi-directionalcommunications module has a powered-down state and a powered-up state,and further comprising a means for signaling the bi-directionalcommunications module to transition from the powered-down state to thepowered-up state.
 27. The system of claim 26, wherein the means forsignaling is mechanical.
 28. The system of claim 26, wherein the meansfor signaling is magnetic.
 29. The system of claim 26, wherein the meansfor signaling is sound or ultra-sound.
 30. The system of claim 26,wherein the means for signaling is infrared.
 31. The system of claim 26,wherein the means for signaling is radio frequency.
 32. The system ofclaim 1, wherein the first personal device is implantable in a person.33. A bi-directional wireless communication system comprising: (a) afirst personal device, the first personal device further comprising: (i)a processor; (ii) a memory; (iii) a power supply; (iv) at least onedetector input; and (v) a long-range bi-directional wirelesscommunications module; (b) a long-range bi-directional wireless networkcommunicating with the long-range bi-directional wireless communicationsmodule; (c) an entity communicating with the first personal device overthe network; and (d) a security mechanism governing informationtransmitted between the first personal device and the entity.
 34. Thesystem of claim 33, wherein the long-range wireless communicationsnetwork is selected from the group consisting of cellular, satellite,paging, narrowband PCS, and narrowband trunk radio.
 35. The system ofclaim 34, further comprising long-range messaging protocols executingover the long-range wireless communications network.
 36. The system ofclaim 35, wherein the long-range messaging protocols are selected fromthe group consisting of wireless application protocol, cellulartelephone protocols, one-way pager protocols, two-way pager protocols,and PCS protocols.
 37. The system of claim 33, wherein the firstpersonal device further comprises a location determination module thatdetermines the geographical location of the first personal device. 38.The system of claim 37, wherein the location determination modulefurther comprises a GPS receiver.
 39. The system of claim 33, whereinthe bi-directional communications module has a powered-down state and apowered-up state, and further comprising a means for signaling thebi-directional communications module to transition from the powered-downstate to the powered-up state.
 40. The system of claim 39, wherein themeans for signaling is selected from the group consisting of mechanical,magnetic, sound or ultrasound, infrared, and radio frequency.
 41. Thesystem of claim 39, wherein the security mechanism encrypts theinformation.
 42. The system of claim 33, wherein the security mechanismemploys authorization by the first personal device.
 43. The system ofclaim 33, wherein the security mechanism employs a key held by an agentand transmitted to the second device.
 44. The system of claim 33,wherein the security mechanism employs a key entered by a user of thefirst personal device.
 45. The system of claim 33, wherein the securitymechanism employs a private key and a public key.
 46. The system ofclaim 33, wherein the security mechanism employs biometrics.
 47. Thesystem of claim 33, wherein the first personal device is implantable ina person.
 48. A bi-directional wireless communication system comprising:(a) a first personal device, the first personal device furthercomprising: (i) a processor; (ii) a memory; (iii) a power supply; (iv)at least one detector input; and (v) a short-range bi-directionalwireless communications module; (b) a second device communicating withthe first personal device, the second device having a short-rangebi-directional wireless communications module compatible with theshort-range bi-directional wireless communications module of the firstpersonal device and also having a long-range bi-directional wirelesscommunications module; and (c) a long-range bidirectional wirelessnetwork communicating with the long-range bi-directional wirelesscommunications module of the second device.
 49. The system of claim 48,wherein the short-range wireless communications further comprisesBLUETOOTH technology.
 50. The system of claim 48, wherein the long-rangewireless communications network is selected from the group consisting ofcellular, satellite, paging, narrowband PCS, and narrowband trunk radio.51. The system of claim 50, further comprising long-range messagingprotocols executing over the long-range wireless communications network.52. The system of claim 51, wherein the long-range messaging protocolsare selected from the group consisting of wireless application protocol,cellular telephone protocols, one-way pager protocols, two-way pagerprotocols, and PCS protocols.
 53. The system of claim 48, wherein thebi-directional wireless communications module of the first personaldevice has a powered-down state and a powered-up state, and furthercomprising a means for signaling the bi-directional wirelesscommunications module of the first personal device to transition fromthe powered-down state to the powered-up state.
 54. The system of claim53, wherein the means for signaling is selected from the groupconsisting of mechanical, magnetic, sound or ultrasound, infrared, andradio frequency.
 55. A method of bi-directional communications,comprising the steps of: (a) detecting an event by a detector connectedto a first personal device; (b) signaling the event to a second deviceusing short-range bi-directional wireless communications between thefirst personal device and the second device; (c) wherein the short-rangewireless communications is BLUETOOTH; and (d) wherein a securitymechanism controls recognition of the event by the second device. 56.The method of claim 55, further comprising the step of transitioning thefirst personal device from a powered-down state to a powered-up state bymeans of an external radio frequency stimulus.
 57. The method of claim56, further comprising the step of signaling the event from the seconddevice to a long-range bi-directional network.